File Download
There are no files associated with this item.
Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1007/s00592-020-01605-6
- Scopus: eid_2-s2.0-85090942793
- PMID: 32939583
- WOS: WOS:000570024200001
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Predictions of diabetes complications and mortality using hba1c variability: a 10-year observational cohort study
Title | Predictions of diabetes complications and mortality using hba1c variability: a 10-year observational cohort study |
---|---|
Authors | |
Issue Date | 2021 |
Citation | Acta Diabetologica, 2021, v. 58, n. 2, p. 171-180 How to Cite? |
Abstract | Introduction: Emerging evidence suggests that HbA1c variability, in addition to HbA1c itself, can be used as a predictor for mortality. The present study aims to examine the predictive power of mean HbA1c and HbA1c variability measures for diabetic complications as well as mortality. Methods: The retrospective observational study analyzed diabetic patients who were prescribed insulin at outpatient clinics of the Prince of Wales Hospital and Shatin Hospital, Hong Kong, from 1 January to 31 December, 2009. Standard deviation (SD), root mean square (RMS), and coefficient of variation were used as measures of HbA1c variability. The primary outcomes were all-cause and cardiovascular mortality. Secondary outcomes were diabetes-related complications. Results: The study cohort consists of 3424 patients, including 3137 patients with at least three HbA1c measurements. The low mean HbA1c subgroup had significantly shorter time-to-death for all-cause mortality (P < 0.001) but not cardiovascular mortality (P = 0.920). The high Hba1c subgroup showed shorter time-to-death for all-cause (P < 0.001) and cardiovascular mortality (P < 0.001). Mean Hba1c and Hba1c variability predicted all-cause as well as cardiovascular-specific mortality. In terms of secondary outcomes, mean HbA1c and HbA1c variability significantly predicted diabetic ketoacidosis/hyperosmolar hyperglycemic state/diabetic coma, neurological, ophthalmological, and renal complications. A significant association between dichotomized HbA1c variability and hypoglycemia frequency was found (P < 0.0001). Conclusion: High HbA1c variability is associated with increased risk of all-cause and cardiovascular mortality, as well as diabetic complications. The association between hypoglycemic frequency, HbA1c variability, and mortality suggests that intermittent hypoglycemia resulting in poorer outcomes in diabetic patients. |
Persistent Identifier | http://hdl.handle.net/10722/330659 |
ISSN | 2023 Impact Factor: 3.1 2023 SCImago Journal Rankings: 0.980 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Lee, Sharen | - |
dc.contributor.author | Liu, Tong | - |
dc.contributor.author | Zhou, Jiandong | - |
dc.contributor.author | Zhang, Qingpeng | - |
dc.contributor.author | Wong, Wing Tak | - |
dc.contributor.author | Tse, Gary | - |
dc.date.accessioned | 2023-09-05T12:12:52Z | - |
dc.date.available | 2023-09-05T12:12:52Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Acta Diabetologica, 2021, v. 58, n. 2, p. 171-180 | - |
dc.identifier.issn | 0940-5429 | - |
dc.identifier.uri | http://hdl.handle.net/10722/330659 | - |
dc.description.abstract | Introduction: Emerging evidence suggests that HbA1c variability, in addition to HbA1c itself, can be used as a predictor for mortality. The present study aims to examine the predictive power of mean HbA1c and HbA1c variability measures for diabetic complications as well as mortality. Methods: The retrospective observational study analyzed diabetic patients who were prescribed insulin at outpatient clinics of the Prince of Wales Hospital and Shatin Hospital, Hong Kong, from 1 January to 31 December, 2009. Standard deviation (SD), root mean square (RMS), and coefficient of variation were used as measures of HbA1c variability. The primary outcomes were all-cause and cardiovascular mortality. Secondary outcomes were diabetes-related complications. Results: The study cohort consists of 3424 patients, including 3137 patients with at least three HbA1c measurements. The low mean HbA1c subgroup had significantly shorter time-to-death for all-cause mortality (P < 0.001) but not cardiovascular mortality (P = 0.920). The high Hba1c subgroup showed shorter time-to-death for all-cause (P < 0.001) and cardiovascular mortality (P < 0.001). Mean Hba1c and Hba1c variability predicted all-cause as well as cardiovascular-specific mortality. In terms of secondary outcomes, mean HbA1c and HbA1c variability significantly predicted diabetic ketoacidosis/hyperosmolar hyperglycemic state/diabetic coma, neurological, ophthalmological, and renal complications. A significant association between dichotomized HbA1c variability and hypoglycemia frequency was found (P < 0.0001). Conclusion: High HbA1c variability is associated with increased risk of all-cause and cardiovascular mortality, as well as diabetic complications. The association between hypoglycemic frequency, HbA1c variability, and mortality suggests that intermittent hypoglycemia resulting in poorer outcomes in diabetic patients. | - |
dc.language | eng | - |
dc.relation.ispartof | Acta Diabetologica | - |
dc.title | Predictions of diabetes complications and mortality using hba1c variability: a 10-year observational cohort study | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00592-020-01605-6 | - |
dc.identifier.pmid | 32939583 | - |
dc.identifier.scopus | eid_2-s2.0-85090942793 | - |
dc.identifier.volume | 58 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 171 | - |
dc.identifier.epage | 180 | - |
dc.identifier.eissn | 1432-5233 | - |
dc.identifier.isi | WOS:000570024200001 | - |